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by fyp 2289 days ago
Why did we give up on containment?

China and South Korea have shown that it's possible. China capped out at only 100k infected for a population of 1.4 billion.

Aiming to let 56% of your population get infected of which more than 3% will die is NOT the solution.

China's strategy seems simple enough. Close off borders of a region, stamp out all existing cases with aggressive testing, then keep the region at 0 cases by requiring mandatory 2 week quarantine before letting anyone in. Do this one region at a time until your country is all clean. Now their biggest problem is teaching the rest of the world this strategy.

8 comments

We have an extreme wealth disparity with many having no savings and no social safety net. We can't force everyone to stay home for months, the economy would collapse.

China maintained draconian levels of control - citizens had cards with their risk level, and were tested frequently when they went to a public space. Have symptoms or some reason to believe you might be infected? You were quarantined from your family and not released until 4+ hours later. If they needed to be kept overnight, they had special hotels to quarantine people in. Citizens there actually listen to what the government tells them to do, and dissent is stamped out. In the states, a lot of people openly don't trust the government.

If we tried to control peoples' lives like that, our citizens would riot. You'd have armed citizens refuse to leave their homes.

They also did things that are unimaginable here - they built an entire hospital in 10 days. They have infrastructure and equipment from SARS that they were able to mobilize.

We aren't China, and we can't accomplish what they've done. Not in eight weeks. We are not prepared for this.

> You'd have armed citizens refuse to leave their homes.

That would be great actually. The problem is armed citizens refusing to stay at home.

>We have an extreme wealth disparity with many having no savings and no social safety net

I was under the impression that the wealth disparity in CHina was even more extreme than in the US. How brainwashed am I?

> We can't force everyone to stay home for months, the economy would collapse.

You could. Just pay everyone $1000/month until it ends.

Paying $1000/month to everyone is $327 billion/month or $3.9 trillion every year. With most people not working you'd have to print that money, destroying the dollar.

Also $1000/month is not even close to enough in most areas to live off. Rent + food + health insurance is a lot more than $1000 for most people.

And what do you pay the businesses that are closed?
We've long been pursuing the supply side economics for far too long. Massive tax cuts and bailouts. Banks came back rather quickly after 2008. The citizens, well, it took a while.

I'm beginning to think that if businesses can't survive for 6 months in a catastrophe, maybe it's better that they die. Moral hazard, you know.

If businesses die, you still have the people to build more businesses. If people die, you'll have neither.

That's an awful lot of people's life savings in their small business that goes poof. A lot of the businesses that can't survive are leaving behind people that are not capable of bringing them back, and people that won't be employed there afterwords.
So a lot of people's life savings have gone poof, not just small businesses.
The staff can be put on unpaid leave since they're getting paid by the government and the rents could be negotiated since the landlord should be getting their mortgage payments paused. I believe those are the main expenses for a brick-and-mortar business.
In Australia today banks will freeze small business customers' loan repayments for up to six months. If you can extend this to rent and other business repayments then many of them should survive.
> You could. Just pay everyone $1000/month until it ends.

Stealth UBI?

>stamp out all existing cases with aggressive testing,

We still lack the capacity for even testing all the people showing significant symptoms. That is why we can't contain it.

The rejection of the WHO tests in order to belatedly come up with our own tests is a massive scandal.

30% of the US population still says they are not concerned about the virus, and if you've seen the number of people still interacting as if nothing has changed in many parts of the country you will pretty quickly come to the conclusion that Chinese measures will be impossible to enforce in the US.

Rapid testing and containment and tracing only works if the people actually comply.

~30% of the population has little reason to fear an infection. That 0.2% risk of death for people under 40 largely includes people with significant underlying heath problems. At least assuming a functional healthcare system etc.

My mother on the other hand is looking at possibly months of near total isolation. At her age it’s a much larger threat.

20-somethings have 0.2% death risk but I read 1% hospitalization rate. So if you are in that age group, and I put you with 99 of your infected friends, one of you ends up in the hospital.

For 30-somethings I believe this goes up to 3%. Then higher from there.

Neither of those are huge but nor are they zero. Neither is a .2% death rate at millions of infections. Those are real people, a lot of them will be young like you and in the hospital. We haven't even gotten into how you will put grandpa or your avuncular older neighbors or the old guy riding the bus at risk. Or how if you fall in that 1-3% that you will be competing for hospital resources with all the other pneumonia cases.

Was looking for more info and found this: https://www.washingtonpost.com/health/2020/03/19/younger-adu...

Edit: is it me or did you edit and tone down your comment? In that case I apologize for putting it so harshly and personally. I will leave it as it is because people need to know this is serious for young people too.

I did edit the post, but my goal was clarity not really a neutral tone. From a public heath perspective it’s important for heathy young people to avoid spreading the disease. But, that’s pushing people to be somewhat deceptive with statistics. So, while I am minimizing contact with others for my personal heath and the general social good I think people may be overestimating their personal risks.

Underlying heath simply seems to play a huge role. In China 10-19 year olds represented 1.2% of the total known cases and 0.9% were 9 or younger. That might have been related to transmission with elderly social circles more widely spreading the disease, or exposure to related diseases etc. However, it’s more likely an indication of untested largely asymptotic cases.

PS: half of the 300 to 400 coronavirus patients treated in intensive care units in Paris were younger than 65

16.8% of the French population is over 65. 50% of their ICU cases are over 65. https://countrymeters.info/en/France That works out to about a 5:1 ratio even including 50-64 year olds at significant risk in the younger population. The avoidance of an age specific breakdown suggests they where aiming to convey a specific message rather than clearly conveying information.

A virus isn't a Bernoulli trial that either kills you or entirely leaves you alone.

You could get sick and require hospitalization.

You could get sick and have permanent lung damage.

You could get sick from something else, or even break your collarbone in a car accident, and be unable to get adequate medical attention because of an outbreak in your region that you helped spread because you had "little reason to fear an infection."

You could infect and kill your mother.

A virus doesn't care how confident you are. It is just a little autonomous machine that uses your body to replicate itself. Don't behave in a way that helps it do that.

I believe that even in young people, 16-20% will need hospital admission/intervention.

That's a lot of people, and how many of those can we expect to have health insurance?

Forget insurance -- if there is no hospital capacity because the system is flooded it doesn't matter if they have it or not. I've read for those who require hospitalization it's a 50% fatality rate. For those who need hospitalization but can't get it, it's closer to 100%.
>I've read for those who require hospitalization it's a 50% fatality rate

I don't think it's that much, I think that it'd be more in the order of 15% of the people who require hospitalization that actually perish.

Well, until you run out of ventilators, that is...

You’re conflating hospitalization with the ICU. Many people end up hospitalized without needing a ventilator.
Containment requires testing. We have lowest amount of testing per capita than any other modern country. Even Italy far exceeds our testing capacity.
> China's strategy seems simple enough. Close off borders of a region

Have a couple of issues with your points.

1. China did not close its borders soon enough, even though the government was aware of the possibility of a large scale incident. This led to the virus's spread to every other continent other than Antarctica. 2. China has the "benefit" of a central government with a citizen database where privacy has no consideration. Combine that with mostly vertical housing, it's easy to make sure no one is able to go outside except for those selected to be a resource liaison. This is impossible in a place like California.

The headline is not true and really does fall under "fake news" this is what happens if no one does anything. Sensationalist and unnecessary
This move by California is pretty much step 1 in China's plan no?

>China's strategy seems simple enough. Close off borders of a region, stamp out all existing cases with aggressive testing, then keep the region at 0 cases by requiring mandatory 2 week quarantine before letting anyone in. Do this one region at a time until your country is all clean. Now their biggest problem is teaching the rest of the world this strategy.

It's in all 50 states at this point. Likely in every major urban area. Too late.

> Aiming to let 56% of your population get infected of which more than 3% will die

Not a single paper to come out in the past 72 hours has a CFR that high. We have been inundated with these very high numbers, but they are based on an almost certainly underestimated infection rate.

Several experts have no opined that the CFR is likely less than 1%, perhaps much less.

A paper today projected it at .04% [0].

0: https://www.reddit.com/r/PrepareInsteadOfPanic/comments/fljz...

I am starting to use such inflated mortality rates as an indicator that the poster/article is either fearmongering or simply not well informed enough to have a worthwhile opinion.
It's maddening. Some of us have been asking this question for the past 5 days and being told we're crazy for not simply believing what is obviously an indefensible denominator. [0]

0: https://news.ycombinator.com/item?id=22580814